Risk and resilience in adolescent suicidal ideation

Abstract

The psychological and social impact of suicide is profound, as schools, or occupational environments, are significantly affected by merely a single suicide, and if no effective measures are taken, researchers fear society is heading for a dramatic rise in suicidal behaviour. Due to the multi-faceted nature of suicide, a range of factors, which can be divided/categorised into risk and protective factors, were found to contribute to suicidal behaviour. Psychosocial factors such as family instability (divorce, violence, and poor parental support) and socio-economic challenges impaired healthy adolescent development, thereby increasing the risk of self-destructive behaviour. The use of ineffective coping strategies is associated with an increased incidence of suicide risk. The focus of this study is to investigate the risk and protective factors underlying adolescent suicidal behaviour in the Northern Cape Province, as well as to explore the stressors experienced by adolescents that could contribute to them having a higher suicide risk. A mixed-method approach was used to analyse data by employing both quantitative and qualitative methods. Quantitatively, a cross-sectional, correlational, and criterion-group design was used, while the Interpretive Phenomenological Analysis (IPA) was used for processing qualitative data. A total of 590 participants from ten schools representative of all six regions within the Northern Cape Province (NCP) have been selected from the NCP. As part of gathering data, the Suicidal Ideation Questionnaire for Adolescents, the Social Stressors and Resources Inventory - Youth Form, the Rosenberg Self-esteem Scale, the Cope Questionnaire, the Hope Scale, and a self-compiled biographical questionnaire were used. Various statistical analyses were conducted such as a variance of analysis that compared the significance of differences between coping strategies between different race groups, a hierarchical regression analysis that investigated the influence of coping strategies on suicidal ideation and a stepwise regression analysis that investigated the unique contributions of stressors, resources and coping strategies on suicidal ideation. The qualitative data was gathered through the use of an open-ended question that asked respondents to write a short paragraph on factors that caused them to feel distressed. Responses were thematically analysed with the use of the IPA method. The qualitative responses emphasised that adolescent’s immediate environment played an important role as a source of stress, especially with regard to their inner experiences of emotion and behaviour regulation and family and friends, as these were reported by a large number of respondents. Stressors associated with the macro-system such as the influence of economic and political spheres were identified by a small number of respondents as a source of stress. Quantitative results indicated the current research samples’ level of suicidal ideation was substantially higher when compared to an American sample. Participants who were previously exposed to suicide or had suicide attempts were identified as falling within the high suicide risk category. White participants reported a lower level of suicidal ideation when compared to Coloured and black groups. Emotion-focused coping strategies significantly contributed to the variance of suicidal ideation for Coloured and white groups, while dysfunctional coping strategies contributed significantly to suicidal ideation for the black group. In the stepwise regression analysis seven variables significantly (on the 1% or 5% level) contributed to the variance of suicidal ideation, explaining a combined variance of 19.27%. Variables that played a protective role (decreasing suicidal ideation) were selfesteem, acceptance as a coping strategy and seeking support for instrumental reasons (seeking tangible support such as advice from others or financial assistance), while variables associated with increased risk (increasing suicidal ideation) were denial, restraint coping, romantic relationships and negative life events. From this study it is recommended that future research focuses on identifying risk and protective factors between specific socio-economic groups as well as the use of longitudinal studies to explore the developmental course of risk and protective factors. The implementation of capacity building programs that will enhance adolescent coping and interpersonal skills was recommended. As a limitation the use of non-South African instruments within a South African context are also further discussed.